"Doctors Do Too Little Technology": A Longitudinal Field Study of an Electronic Healthcare System Implementation

With the strong ongoing push toward investment in and deployment of electronic healthcare (e-healthcare) systems, understanding the factors that drive the use of such systems and the consequences of using such systems is of scientific and practical significance. Elaborate training in new e-healthcare systems is not a luxury that is typically available to healthcare professionals-i.e., doctors, paraprofessionals (e.g., nurses) and administrative personnel-because of the 24 x 7 nature and criticality of operations of healthcare organizations, especially hospitals, thus making peer interactions and support a key driver of or barrier to such e-healthcare system use. Against this backdrop, using social networks as a theoretical lens, this paper presents a nomological network related to e-healthcare system use. A longitudinal study of an e-healthcare system implementation, with data gathered from doctors, paraprofessionals, administrative personnel, patients, and usage logs lent support to the hypotheses that: (1) ingroup and outgroup ties to doctors negatively affect use in all user groups; (2) ingroup and outgroup ties to paraprofessionals and administrative personnel positively affect use in both those groups, but have no effect on doctors' use; and (3) use contributes positively to patient satisfaction mediated by healthcare quality variables-i.e., technical quality, communication, interpersonal interactions, and time spent. This work contributes to the theory and practice related to the success of e-healthcare system use in particular, and information systems in general.